Exploration of delirium assessment and management in a hospice inpatient unit: A mixed methods study

Elizabeth Arnold*, Catherine Fairfield, Juliet Spiller, Anne Finucane

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Delirium is common across all palliative care settings. Guidelines exist to support the care of terminally ill people who develop delirium; yet the evidence base is limited. Recent surveys of palliative care specialists have suggested clinical practice is variable. 

Aim: To explore delirium assessment and management in a hospice inpatient setting. 

Methods: A mixed-methods study comprising a retrospective case note review of 21 patients admitted to a hospice inpatient unit and semi-structured interviews with seven hospice inpatient doctors and nurses. 

Results: A total of 62% of patients were screened for delirium on admission using the 4 As tool (4AT). The period prevalence of delirium was 76% during the 2-week study period. The term 'delirium' was documented infrequently in case notes, compared to other more ambiguous terms. Interview data suggested that nurses were unfamiliar with delirium screening tools. 

Conclusion: Lack of awareness about delirium screening tools and the infrequent use of the term 'delirium' may suggest that delirium goes under-recognised and under-treated. Further education and research are required to support the care of terminally ill people with delirium.

Original languageEnglish
Pages (from-to)506-514
JournalInternational Journal of Palliative Nursing
Volume28
Issue number11
Early online date23 Nov 2022
DOIs
Publication statusPublished - Nov 2022

Keywords / Materials (for Non-textual outputs)

  • delirium
  • palliative
  • hospice
  • assessment
  • management
  • screening
  • mixed methods
  • interviews

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